[The Nocturnal Respiratory Rate in COPD Patients of Varying GOLD Severity with/without Nicotine Consumption: Calculation by Means of Breath Sound Analysis]

Respiratory rate is an important risk marker and enables early detection of critically ill and vulnerable patients in clinical routine. The aim of this pilot study with 31 patients (COPD severity levels II - IV) was to determine the mean nocturnal respiratory rate based on breath sound recordings and to investigate the dependence of respiratory rate on COPD severity level and smoker status. The mean respiratory rate of the total collective was 19/min. For the COPD-GOLD severity levels, no significant differences in mean respiratory rate could be observed. When nicotine consumption is taken into account, active smokers showed a significantly higher mean respiratory rate of 20.84 ± 4.45/min compared to non-smokers with 17.41 ± 3.14/min (p < 0.05). In addition, active smokers in the study were significantly more frequent among patients with night-time wheezing (60 % vs. 23.8 %). This might suggest that smokers need to perform increased breathing work with increased breathing rate to compensate for oxygen deficiency in bronchial obstruction. The results of the present study show that with the acoustic recording of breath sounds, a reliable representation and calculation of the breath frequency is possible.

Design of a light-gated proton channel based on the crystal structure of Coccomyxa rhodopsin

The light-driven proton pump Coccomyxa subellipsoidea rhodopsin (CsR) provides-because of its high expression in heterologous host cells-an opportunity to study active proton transport under controlled electrochemical conditions. In this study, solving crystal structure of CsR at 2.0-Å resolution enabled us to identify distinct features of the membrane protein that determine ion transport directivity and voltage sensitivity. A specific hydrogen bond between the highly conserved Arg⁸³ and the nearby nonconserved tyrosine (Tyr¹⁴) guided our structure-based transformation of CsR into an operational light-gated proton channel (CySeR) that could potentially be used in optogenetic assays. Time-resolved electrophysiological and spectroscopic measurements distinguished pump currents from channel currents in a single protein and emphasized the necessity of Arg⁸³ mobility in CsR as a dynamic extracellular barrier to prevent passive conductance. Our findings reveal that molecular constraints that distinguish pump from channel currents are structurally more confined than was generally expected. This knowledge might enable the structure-based design of novel optogenetic tools, which derive from microbial pumps and are therefore ion specific.

Structure and Nanomechanics of Dry and Hydrated Intermediate Filament Films and Fibers Produced from Hagfish Slime Fibers

Intermediate filaments (IFs) are known for their extensibility, flexibility, toughness, and their ability to hydrate. Using keratin-like IFs obtained from slime fibers from the invertebrate Atlantic hagfish ( Myxine glutinosa), films were produced by drop-casting and coagulation on the surface of a MgCl₂ buffer. Drop-casting produced self-supporting, smooth, and dense films rich in β-sheets (61%), whereas coagulation formed thin, porous films with a nanorough surface and a lower β-sheet content (51%). The films hydrated and swelled immediately when immersed in water and did not dissolve. X-ray diffraction showed that the β-crystallites remained stable upon hydration, that swelling presumably happens in the amorphous C-terminal tail-domains of the IFs, and that high salt conditions caused a denser network mesh size, suggesting polyelectrolyte behavior. Hydration resulted in a roughly 1000-fold decrease in apparent Young's modulus from 10⁹ to 10⁶ Pa as revealed by atomic force microscopy nanoindentation. Nanoindentation-based power-law rheology and stress-relaxation measurements indicated viscoelasticity and a soft-solid hydrogel character for hydrated films, where roughly 80% of energy is elastically stored and 20% is dissipated. By pulling coagulation films from the buffer interface, macroscopic fibers with highly aligned IF β-crystals similar to natural hagfish fibers were produced. We propose that viscoelasticity and strong hydrogen bonding interactions with the buffer interface are crucial for the production of such long biomimetic fibers with aligned β-sheets. This study demonstrates that hagfish fiber IFs can be reconstituted into functional biomimetic materials that are stiff when dry and retain the ability to hydrate to become soft and viscoelastic when in water.

Renal Cell Carcinoma (RCC) Tumors Display Large Expansion of Double Positive (DP) CD4+CD8+ T Cells With Expression of Exhaustion Markers

Checkpoint inhibitors target the inhibitory receptors expressed by tumor-infiltrating T cells in order to reinvigorate an anti-tumor immune response. Therefore, understanding T cell composition and phenotype in human tumors is crucial. We analyzed by flow cytometry tumor-infiltrating lymphocytes (TILs) from two independent cohorts of patients with different cancer types, including RCC, lung, and colon cancer. In healthy donors, peripheral T cells are usually either CD4+ or CD8+ with a small percentage of CD4+ CD8+ DP cells (<5%). Compared to several other cancer types, including lung, and colorectal cancers, TILs from about a third of RCC patients showed an increased proportion of DP CD4+CD8+ T cells (>5%, reaching 30–50% of T cells in some patients). These DP T cells have an effector memory phenotype and express CD38, 4-1BB, and HLA-DR, suggesting antigen-driven expansion. In fact, TCR sequencing analysis revealed a high degree of clonality in DP T cells. Additionally, there were high levels of PD-1 and TIM-3 expression on DP T cells, which correlated with higher expression of PD-1 and TIM-3 in conventional single positive CD8 T cells from the same patients. These results suggest that DP T cells could be dysfunctional tumor-specific T cells with the potential to be reactivated by checkpoint inhibitors.

Circulating T Cell Subpopulations Correlate With Immune Responses at the Tumor Site and Clinical Response to PD1 Inhibition in Non-Small Cell Lung Cancer

Agents targeting the PD1-PDL1 axis have transformed cancer therapy. Factors that influence clinical response to PD1-PDL1 inhibitors include tumor mutational burden, immune infiltration of the tumor, and local PDL1 expression. To identify peripheral correlates of the anti-tumor immune response in the absence of checkpoint blockade, we performed a retrospective study of circulating T cell subpopulations and matched tumor gene expression in melanoma and non-small cell lung cancer (NSCLC) patients. Notably, both melanoma and NSCLC patients whose tumors exhibited increased inflammatory gene transcripts presented high CD4⁺ and CD8⁺ central memory T cell (CM) to effector T cell (Eff) ratios in blood. Consequently, we evaluated CM/Eff T cell ratios in a second cohort of NSCLC. The data showed that high CM/Eff T cell ratios correlated with increased tumor PDL1 expression. Furthermore, of the 22 patients within this NSCLC cohort who received nivolumab, those with high CM/Eff T cell ratios, had longer progression-free survival (PFS) (median survival: 91 vs. 215 days). These findings show that by providing a window into the state of the immune system, peripheral T cell subpopulations inform about the state of the anti-tumor immune response and identify potential blood biomarkers of clinical response to checkpoint inhibitors in melanoma and NSCLC.

Phosphorus saturation and superficial fertilizer application as key parameters to assess the risk of diffuse phosphorus losses from agricultural soils in Brazil

In Brazil, a steady increase in phosphorus (P) fertilizer application and agricultural intensification has been reported for recent decades. The concomitant P accumulation in soils potentially threatens surface water bodies with eutrophication through diffuse P losses. Here, we demonstrated the applicability of a soil type-independent approach for estimating the degree of P saturation (DPS; a risk parameter of P loss) by a standard method of water-soluble phosphorus (WSP) for two major soil types (Oxisols, Entisols) of the São Francisco catchment in Brazil. Subsequently, soil Mehlich-1P (M1P) levels recommended by Brazilian agricultural institutions were transformed into DPS values. Recommended M1P values for optimal agronomic production corresponded to DPS values below critical thresholds of high risks of P losses (DPS=80%) for major crops of the catchment. Higher risks of reaching critical DPS values due to P accumulation were found for Entisols due to their total sorption capacities being only half those of Oxisols. For complementary information on soil mineralogy and its influence on P sorption and P binding forms, Fourier transformation infrared (FTIR) spectroscopic analyses were executed. FTIR analyses suggested the occurrence of the clay minerals palygorskite and sepiolite in some of the analyzed Entisols and the formation of crandallite as the soil specific P binding form in the investigated Oxisols. Palygorskite and sepiolite can enhance P solubility and hence the risk of P losses. In contrast, the reshaping of superphosphate grains into crandallite may explain the chemical processes leading to previously observed low dissolved P concentrations in surface runoff from Oxisols. To prevent high risk of P losses, we recommend avoiding superficial fertilizer application and establishing environmental thresholds for soil M1P based on DPS. These measures could help to prevent eutrophication of naturally oligotrophic surface waters, and subsequent adverse effects on biodiversity and ecosystem function.

Effect of ionic strength and seawater cations on hagfish slime formation

The defensive slime of hagfish consists of a polyanionic mucin hydrogel that synergistically interacts with a fiber network forming a coherent and elastic hydrogel in high ionic strength seawater. In seawater, the slime deploys in less than a second entrapping large quantities of water by a well-timed thread skein unravelling and mucous gel swelling. This rapid and vast hydrogel formation is intriguing, as high ionic strength conditions generally counteract the swelling speed and ratio of polyelectrolyte hydrogels. In this work we investigate the effect of ionic strength and seawater cations on slime formation dynamics and functionality. In the absence of ionic strength skeins swell radially and unravel uncontrolled, probably causing tangling and creating a confined thread network that entraps limited water. At high ionic strength skeins unravel, but create a collapsed and dense fiber network. High ionic strength conditions therefore seem crucial for controlled skein unraveling, however not sufficient for water retention. Only the presence of naturally occurring Ca2+ or Mg2+-ions allowed for an expanded network and full water retention probably due to Ca2+-mediated vesicle rupture and cross-linking of the mucin. Our study demonstrates that hagfish slime deployment is a well-timed, ionic-strength, and divalent-cation dependent dynamic hydrogel formation process.

Rho-kinase inhibitors do not expand hematoma volume in acute experimental intracerebral hemorrhage

Rho‐associated kinase (ROCK) is an emerging target in acute ischemic stroke. Early pre‐hospital treatment with ROCK inhibitors may improve their efficacy, but their antithrombotic effects raise safety concerns in hemorrhagic stroke, precluding use prior to neuroimaging. Therefore, we tested whether ROCK inhibition affects the bleeding times, and worsens hematoma volume in a model of intracerebral hemorrhage (ICH) induced by intrastriatal collagenase injection in mice. Tail bleeding time was measured 1 h after treatment with isoform‐nonselective inhibitor fasudil, or ROCK2‐selective inhibitor KD025, or their vehicles. In the ICH model, treatments were administered 1 h after collagenase injection. Although KD025 but not fasudil prolonged the tail bleeding times, neither drug expanded the volume of ICH or worsened neurological deficits at 48 h compared with vehicle. Although more testing is needed in aged animals and comorbid models such as diabetes, these results suggest ROCK inhibitors may be safe for pre‐hospital administration in acute stroke.

In-depth study of in-trap high-resolution mass separation by transversal ion ejection from a multi-reflection time-of-flight device

The recently introduced method of ion separation by transversal ejection of unwanted species in electrostatic ion-beam traps and multi-reflection time-of-flight devices has been further studied in detail. As this separation is performed during the ion storage itself, there is no need for additional external devices such as ion gates or traps for either pre- or postselection of the ions of interest. The ejection of unwanted contaminant ions is performed by appropriate pulses of the potentials of deflector electrodes. These segmented ring electrodes are located off-center in the trap, i.e., between one of the two ion mirrors and the central drift tube, which also serves as a potential lift for capturing incoming ions and axially ejecting ions of interest after their selection. The various parameters affecting the selection effectivity and resolving power are illustrated with tin-cluster measurements, where isotopologue ion species provide mass differences down to a single atomic mass unit at ion masses of several hundred. Symmetric deflection voltages of only 10 V were found sufficient for the transversal ejection of ion species with as few as three deflection pulses. The duty cycle, i.e., the pulse duration with respect to the period of ion revolution, has been varied, resulting in resolving powers of up to several tens of thousands for this selection technique.

The degree of phosphorus saturation of agricultural soils in Germany: Current and future risk of diffuse P loss and implications for soil P management in Europe

Decades of intensive agricultural production with excessive application of P fertilizer have resulted in the accumulation of P in soils, threatening water bodies in most industrialized countries with eutrophication. In our study, we elucidated the risk of P loss of German agricultural soils by transforming provided monitoring data of plant-available P determined by the calcium-acetate-lactate (PCAL) and double-lactate method (PDL) into the degree of phosphorus saturation (DPS). As water-soluble phosphorus (WSP) is correlated to DPS, we derived a pedotransfer function (PTF) between PCAL and WSP for different soil types. Considering all soils together resulted in WSP=0.1918×PCAL (R²=0.80, n=54). Subsequently, risk parameters DPS and EPC0 were calculated from PCAL and PDL monitoring data (n>337,000) by using the determined PTF and soil type-independent correlations with WSP, as published in an earlier study. Calculated DPS values from monitoring data indicated high risks of dissolved P loss for >76% of German arable soils. Recent suggestions by the Association of German Agricultural Analytical and Research Institutes (VDLUFA) to reduce recommended PCAL levels are crucial for the reduction of P loss risks in the future. The accuracy of predicted DPS and EPC0 values by CAL and other methods used in Europe to estimate plant-available P is limited by the soil type-dependency of these methods. Consequently, we recommend considering WSP as an agri-environmental soil P test across Europe. Our results indicate that a WSP level in soils can be defined that constitutes a reasonable compromise between the securing of agronomic production and the fulfillment of environmental goals.

Nanosecond X-Ray Photon Correlation Spectroscopy on Magnetic Skyrmions

We report an x-ray photon correlation spectroscopy method that exploits the recent development of the two-pulse mode at the Linac Coherent Light Source. By using coherent resonant x-ray magnetic scattering, we studied spontaneous fluctuations on nanosecond time scales in thin films of multilayered Fe/Gd that exhibit ordered stripe and Skyrmion lattice phases. The correlation time of the fluctuations was found to differ between the Skyrmion phase and near the stripe-Skyrmion boundary. This technique will enable a significant new area of research on the study of equilibrium fluctuations in condensed matter.

Hagfish slime exudate stabilization and its effect on slime formation and functionality

Hagfish produce vast amounts of slime when under attack. The slime is the most dilute hydrogel known to date, and is a highly interesting material for biomaterial research. It forms from a glandular secrete, called exudate, which deploys upon contact with seawater. To study slime formation ex vivo and to characterize its material properties, stabilization of the sensitive slime exudate is crucial. In this study, we compared the two main stabilization methods, dispersion in high osmolarity citrate/PIPES (CP) buffer and immersion in oil, and tested the influence of time, temperature and pH on the stability of the exudate and functionality of the slime. Using water retention measurements to assess slime functionality, we found that CP buffer and oil preserved the exudate within the first 5 hours without loss of functionality. For longer storage times, slime functionality decreased for both stabilization methods, for which the breakdown mechanisms differed. Stabilization in oil likely favored temperature-sensitive osmotic-driven swelling and rupture of the mucin vesicles, causing the exudate to gel and clump. Extended storage in CP buffer resulted in an inhibited unraveling of skeins. We suggest that a water soluble protein glue, which mediates skein unraveling in functional skeins, denatures and gradually becomes insoluble during storage in CP buffer. The breakdown was accentuated when the pH of the CP buffer was raised from pH 6.7 to pH 8.5, probably caused by increased denaturation of the protein glue or by inferior vesicle stabilization. However, when fresh exudate was mixed into seawater or phosphate buffer at pH 6-9, slime functionality was not affected, showing pH insensitivity of the slime formation around a neutral pH. These insights on hagfish exudate stabilization mechanisms will support hagfish slime research at a fundamental level, and contribute to resolve the complex mechanisms of skein unraveling and slime formation.

Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"?

OBJECTIVES

Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients.

METHODS

All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection.

RESULTS

Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR.

CONCLUSIONS

HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.

Application of Large-Scale Inversion Algorithms to Hydraulic Tomography in an Alluvial Aquifer

Large-scale inversion methods have been recently developed and permitted now to considerably reduce the computation time and memory needed for inversions of models with a large amount of parameters and data. In this work, we have applied a deterministic geostatistical inversion algorithm to a hydraulic tomography investigation conducted in an experimental field site situated within an alluvial aquifer in Southern France. This application aims to achieve a 2-D large-scale modeling of the spatial transmissivity distribution of the site. The inversion algorithm uses a quasi-Newton iterative process based on a Bayesian approach. We compared the results obtained by using three different methodologies for sensitivity analysis: an adjoint-state method, a finite-difference method, and a principal component geostatistical approach (PCGA). The PCGA is a large-scale adapted method which was developed for inversions with a large number of parameters by using an approximation of the covariance matrix, and by avoiding the calculation of the full Jacobian sensitivity matrix. We reconstructed high-resolution transmissivity fields (composed of up to 25,600 cells) which generated good correlations between the measured and computed hydraulic heads. In particular, we show that, by combining the PCGA inversion method and the hydraulic tomography method, we are able to substantially reduce the computation time of the inversions, while still producing high-quality inversion results as those obtained from the other sensitivity analysis methodologies.

Spatial variation in nitrogen dioxide concentrations and cardiopulmonary hospital admissions

BACKGROUND

Air pollution episodes are associated with increased cardiopulmonary hospital admissions. Cohort studies showed associations of spatial variation in traffic-related air pollution with respiratory and cardiovascular mortality. Much less is known in particular about associations with cardiovascular morbidity. We explored the relation between spatial variation in nitrogen dioxide (NO₂) concentrations and cardiopulmonary hospital admissions.

METHODS

This ecological study was based on hospital admissions data (2001-2004) from the National Medical Registration and general population data for the West of the Netherlands (population 4.04 million). At the 4-digit postcode area level (n=683) associations between modeled annual average outdoor NO₂ concentrations and hospital admissions for respiratory and cardiovascular causes were evaluated by linear regression with the log of the postcode-specific percentage of subjects that have been admitted at least once during the study period as the dependent variable. All analyses were adjusted for differences in composition of the population of the postcode areas (age, sex, income).

RESULTS

At the postcode level, positive associations were found between outdoor NO₂ concentrations and hospital admission rates for asthma, chronic obstructive pulmonary disease (COPD), all cardiovascular causes, ischemic heart disease and stroke (e.g. adjusted relative risk (95% confidence interval) for the second to fourth quartile relative to the first quartile of exposure were 1.87 (1.46-2.40), 2.34 (1.83-3.01) and 2.81 (2.16-3.65) for asthma; 1.44 (1.19-1.74), 1.50 (1.24-1.82) and 1.60 (1.31-1.96) for COPD). Associations remained after additional (indirect) adjustment for smoking (COPD admission rate) and degree of urbanization.

CONCLUSIONS

Our study suggests an increased risk of hospitalization for respiratory and cardiovascular causes in areas with higher levels of NO₂. Our findings add to the currently limited evidence of a long-term effect of air pollution on hospitalization. The ecological design of our study is a limitation and more studies with individual data are needed to confirm our findings.

On the Optimal Number of Subdomains for Hyperbolic Problems on Parallel Computers

The computational complexity for parallel implementation of multidomain spectral methods is studied to derive the optimal number of subdomains, q, and spectral order, n, for the numerical solution of hyperbolic problems. The complexity analysis is based on theoretical results that predict error as a function of (q,n) for problems having wavelike solutions. These are combined with a linear com munication cost model to study the impact of communica tion overhead and imposed granularity on the optimal choice of ( q,n) as a function of the number of processors. It is shown that, for present-day multicomputers, the im pact of communication overhead does not significantly shift ( q,n) from the optimal uniprocessor values and that the effects of granularity are more important.